soal NBSS 2009

Jumat, 10 Juli 2009

129.which of the following disorder is the most common mental disorder diagnosed by liaison psychiatrist in general hospital?
a. mood disorder
b. schizophrenia
c. delirium
d. delusional disorder
e. organic personalities disorder

170. according to diagram anatomical structure of hearing people is?
a. tympani membrane
b. external meatus
c. ossicle
d. outer hair cell
e. auricle

4. 44 y.o man crocodile tears syndrome has spontaneous lacrimation during eating because of misdirection regenerating autonomic nerve fibers. Which of the following nerve has been injured?
a. facial nerve proximal to the geniculate ganglion
b. auriculotemporal nerve
c. chorda tympani in the infratemporal fossa
d. facial nerve at the stylomastoid fossa
e. lacrimal nerve

143. sign symtomp meningkatnya ICP
e. menurunnya kesadaran, headache vomiting, papil edema

93. orang gelisah, hiperaktif dikasih obat amphetamine

175. turring movement organ
a. macula
b. semicircular canal

92. stabing pain extended along her left mandibule. Which of the following most corvected diagnosed on her condition.
a. cluster headache
b. migraine
c. trigeminal neuralysis
e. glossopharyngeal neurologia

186. 10 y.o male. Got persistent headache and ataxia
Head CT: mass involving cerebellar vermis
CSF: abnormal cell
Microscopic: spindle cell and carrot shape forming rosette
Appropriate diagnosis?
a. Pitocytic astrocytoma
b. Ependyoma
c. Neuroblastoma
d. Choroid plexus papiloa
e. Medulloblastoma

24 y.o male
Not yet spoken first clear word yet
Can’t understand what people say to him
Does not play with 3 year old brother
Make odd repetitive movement with his hand
a. Autistic
b. Rett disorder
c. Disintegrative childhooh development
d. Asperger
e. Pervasive developmental disorder not otherwise specified
135. most appropriate diagnosis?
136. which os more common in girls than boys?

41. congenital eye anomaly on eye lid. Eye cover by skin. The eye are small and defect. What is it?
a. coloboma
b. sryptothalmus

42. 4 y.o speech delay, 16 kg, 70 cm, HC= 45 cm, IQ= 30
Face long, large ears, short stature, VRA, BRA= normal limit, FRAXA out x927,3
a. Turner syndrome
b. Klinefelter
c. Down syndrome
d. Smith-lemli-opitz syndrome

143.the doctor in charge performs light reflex to the patient, which CN:
d. V,VII

171. 3 y.o boy. Mother complained his child cant speak words. Hearing exam yg paling pas:
a. conductive hear loss left ear
b. conductive hear loss right ear
c. sensorineural loss left ear
d. sensorineural loss right ear
e. bilateral sensorineural loss

121. 42 y.o man, wife noticed that her husband has been called of work from ill, when he cant wake up in the morning, because he cant get out of the bed, he also loss apetite in food, interest in sex, sleep for hours each day, his husband not sure for continue on living, PE normal. What is the most likely disorder from info above?
a. depressive
b. anxiety

123. orang yang rentan tehadap penyakit ini
a. anti social disorder
b. low self esteem
c. stonr ego
d. weak super ego

173. test yang memprovokasi BPPV
a. hallpike

95. seorang pasien headache without fever, beberapa minggu sakit kepala parah + nausea dan vomiting, 1 minggu sebelumnya terjadi hemiparesis. Pemeriksaan apa yang paling dulu dilakukan?
a.head CT scan
b. head X-ray
c. lumbar puncture
d. head MRI

145. patient with head injury decrase consciousness, which of the following is the most likely prompt treatment?
a. head x-ray
b. GCS
c. airway, breathing and circulating screening
d. head CT-scan
e. blood gas analysis

116. 23y.o female, nausea, vomit, diare, sweating, watry eyes, rhinnorhea, muscle aches, substance used. Pas substance dilepas jadi symtom2 tadi
PE: pupil dilate (+)
Dysphoric mod, insomnia
Prompt treatment?
a. Rehab
b. detox
c. Antagonist opiate
d. Symptomatic treatment

?. a patient is referred for an audiological evaluation following an otologic exam, tuning fork test revealed anormal rinne weber, if this patient is suspected for faking his hearing problem, what exam should follow?
b. Tympanometry
c. Audimetry
d. OAE
e. Whisper test

141. seseorang mengalami consciousness, tapi ada masa sadara diantaranya, masa tersebut adalah?
a. cushing
b. lucid interval

143. the doctor suspect peningkatan ICP, sign and symptom?
a. vertigo, headache,pupil edema, vomit
b. vomit, conscious turun, tachycardia, vertigo
c. papil edema, vertigo, vomit, conscious turun
d. headache, papil edema, vomit, tachcardi
e. headache, papil edema, vomit, consc turun

45 y.o male, 5 moths ago headache without fever, headache became worst, I month ago headache with vomit, for the lst 1 week decrase sensation over the left side of the body.
94. which of the following disease is the most likely suffer of the patient? occupying lesion
b. hemmorhagic stroke
c. ischemic stroke
d. meningitis
e. enchepahlitis

144. 30 y.o male, was hit by car, he was mumble and when was stimulated by pain is eyes opened and hand withdrawal. Doctor suspect the patient was fracture in skull base in middle region. Which of the following sign is should be elicited?
a. bells palsy
b. raccoon eye
c. baltk sign
d. rinnorhea
e. decrease of consciousness

1.3 y.o female thyroid surgery to papiloma carcinoma, structure yg impaired?
a.relax vocal cord
c. tense vocal cord
e.abduct vocal cord

43. evaluating molecular diagnostic, tech of blood, which is more efficient and reliable?
a. karyotype
c. northern
d. western
e. southern

3.45 y.o wmen suffer numbness over her tip nose. Which nerve damage?
a.Opthalamic division CN V
b.maxillary div CN V
c.mandibulary div CN V
d.facial .n
e.auriculotemporal n.

53. in schizophrenia, miningkatnya aktivitas dopaminergic. Which receptor activating of this neurotransmitter?
a.D1->inhibit adenyl.cyclase
b.D2->inhibit adenyl.cyclase
c.D3->activate adenyl.cyclase
d.D4->stimulate phosphatchyl
e.D5->modulate Ca channel

26.physisian perform exam:
-unable to speak/write
-can understand command
b.angular gyrus
e.primary auditory

76.thrombo embolic stroke mostly caused by?
c.carotid a.
d.opthalamic a.
e.vertebral a.

111.eccentric, isolated, lonely, social withdrawal, cold emotion, not interested in creating close relationship, no hallucination, no delusion: personality disorder?
e.border line

26.the development “neurotic sign and symptom” is tied to certain condition, kondisi tersebut cirirnya dalah inner conflict between drive and fear that prevent drive discharge?

133.ADHD confirm diagnosis?
d.present only at school
e.present at least 2…………

96.yang sangat berhubungan dengan high ICP
a.left central CN 7
b.paresis CN 6 bilaterally
c.left central CN 12
d.left hemisparesis
e.brisk left fisiologis reflex

146.bayi 6 bulan, CP, delay motor development, primitive reflex masih ada. Clinical feature pda anak tersebut?
a.increase muscle tone
b.positive ATNR @ 4 months
c.decrease cognitive F(x) over time
e.increase head circumference first than poor growth

for question no 80 until 83, refer to the scenario below:
a 65 y.o lady, formal lecturer of university retired 6 years ago (one year before the retire age). She was brought to doctor by her daughter whith chief complain of memory impairment. The dourhter noticed that she has been forgetting her personal belongins and need to find them for the last 4 years. She left her bag at the aircraft 2 years ago. She mixed up the cell-phone number of her sons a year ago. Sometime she gave” big tips” to waiter in the restaiurant and cashier at beauty pallor. One year ago, she was very angry with grandson complains that cookies she made are not nice anymore.

80.which of the following is the most appropriate hypothesis for his condition at this age?
a.age associated memory impairment
b.mild cognitive impairment
e.normal sadness in elders

now she become irritable, sometimes she can not”keep in track” while talking during gathering with her group. She is not able to find her way home in her families street. Cooking is not interest to her. She was brought to specialist center. Her vital sign are normal wxcept her blood preasure 150/190 mmHg. Neurological exam reveal normal findings. Her routine lab test normal.the total score of mini mental state exam (MMSE) was 20: she didn’t know the exact date of the month, day of the week, level of the floor. She couldn’t recall the 3 unrelated words and had difficulties in performiong praxis tasks.

81.which of the following is the most likely diagnosed for her condition nor?
a.senile dementia
b.vasculr dementia
c.dementia with lewi’s body
d.dementia of alzaimer type
e.frontotemporal lobe dementia

82.based on current knowledge, what is the main neurotransmitter involved in the case below?

83.which of the following radio imaging findings that may support your diagnosis in the case below?
a.diffuse cortical atrophy
b.mild hydrocephalus
c.medial temporal lobe atrophy
d.basal ganglia trophy
e.frontotemporal atrophy

84.25y.o mechanic of toyota service center came to neurologist with the chief complain difficulty in finding words to say after stroke 3 months ago. He still can understand confersation, he gives the right answer to questions even-thought he speak in short phrase and sometime in wrong spelling. He is totally independent in activities of daily living and still well engage in his job. Based on information above, which is the following is the most suitable hypothesis of his neurobehavioral complain?
b.lingual apraxia
c.buccal appraxia

85.22 y.o man got a traffic accident 1 hour before hospital addmission. He had a severe head trauma. In the E.R the doctor in charge found that his pupil was anisocor. The left pupil was smaller in diameter but still gave a light reflex. CT-scan showed a large epidural hemmorhage. Which of the following is the light reflex pathway?
a.afferent:CN 2 efferent: CN 3
b.afferent:CN 2 efferent:CN 4
c.afferent:cn3 efferent: cn 4
d.afferent: cn 3 efferent: cn 6
e.afferent: cn 4 efferent: cn 6

72.which of the following is the most likely caused?
a.rupture of aneurysma charcot’s bouchart
b.stenos of arteric
c.embolus from cardinal
d.rupture of bery aneurysma
e.embolus artery to artery

73.which of the following is th elocation of the vascular damage in this patient?
a.medial cerebral artery
b.vertebral artery
c.penetran artery
d.system of circulus willisi
e.opthalamica artery

74.this patient is given mannitol 20%, which of the following is the most appropriate purpose?
a.decrease of hypertention
b.decrease of hypoglycemi
c.decrease of cerebral oedema
d.decrease of hyper lipidemia
e.decrease of hyper coagulatic

75.50 y.o woman has history ofhypertention, this problem increase intra cerberal bleeding, which of the following aneurysma is the most likely to abrupt?
a.charcol’s buchort aneurysm
b.saccular aneurysm
c.bery aneurysm
d.mycotic aneurysm
e.congenital aneyrysm

76.thrombo embolic stroke,mostly cause by atheroma in?
a.anterior cerebelar artery
b.posterior cerebelar artery
c.carothid artery
d.opthalamic artery
e.vertebral artery

for question no 77 and 78, refer to scenario below
50 y.o woman is diagnosed with cardio emboli stroke

77.which of the following is the most likely caused?
c.cardiac disease

78.which of the following drug should be used for preventtion of reccurent above stroke?

79.which of the following is the most likely unmodifable risk factor stroke?
d.cardiac disease

123.which of the following is most likely characteristic person prone of the disorder?
a.paranoid personality
b.antisocial personality
c.storng egb
d.low self esteem
e.weak super ego

154.bayi berumur 2 thn hanya bisa mumble, belum bisa mengucapkan mama, perkembangan motorik lain baik.
a.gangguan kognitif
b.ganggoan motorik
c.gnagguan bahasa

45.a mental retarded female infant had alow set, malformation of ears, prominent of ociput, a chromosomal abnormality was suspected, which of the following likely diagnosed?
a.cri-du cat syndrome
b.down syndrome
c.edward sndrome
d.patau syndrome
e.turner syndrome

48.cara memeriksa kongenital malformation diatas?
a.obstetric exam
b.AFP pada maternal serum
c.AFP pad fetal serum
e.pemeriksaan mikroskopik pada cairan amnion

148. seorang anak 6 bulna menderitracerebral palsy, terdapat persisten primitive reflex dan delayed motor development, kemicterus adalah salah satu penyebaba CP. Temuan histologi?
a.periventricular leukomalacia
b.basala gangalia abnormalities
c.brain calcification
d.cerebral infarc
e.brain atrophy

40.female 45 y.o BPPV which structure is involved?
a.endolymph on S media
c.endolymph on s tympani

155.male 5 y.o baru bisa ngomong 1-2 kata, tidakm main dengan teman sebayanya…
Jawab: mental retard yaitu 10%

149.anak cerebral palsy yang keganggu awal
Jwb: poor head movement

157.2 y.o girl -> languane mildstone?
Jwb: snetense of 2-3 words

159. cerebral palsy tipe apa? Increase muscle tone di low extremities, slight increase muscle tone upper extremities, Baru berjalan umur 2,5 tahun.

175.organ that detect changing position of the head, ex head inturn?
a.oragan of corti
b.sacule and utricule
c.tectorial membrane
d.semisircular canal

63.male 35 y.o mengalami dropping eyelid, kemudian ditreatment dengna tablet, tapi kemudian timbul diare, nausea dan flushing. Tablet tersebut?

144. 30 y.o male came to E.R, previously hit by car, he mumble inresponse to painful stimulate he open eyes and withdrawal of limbs. Doctor found fracture in skull base in medial fossa. Which of the following sign should be elicited
a.bell’s palsy
b.racoon eye’s sign
c.battle’s sign
e.decrease of consciousness

194. CSF exam: gross CSF abnormal, cell count high, protein content high, sugar low. Diagnose?
a.viral enchepalitis
b.viral meningitis
c.bacterial meningitis
d.brain absess
e.cerebral malformation

164.70 y.o woman cant control her bladder, there is alome with a dimple at the lumbosacral. Milestone abnormal. What is the best radiology proceduret to confirm the diagnose above?

98.NE found horizontal nystagmus(fast commonent to the left and fatigue), no CN palsy, no limb weakness, no sensory disturbance, normal physiological reflex. Which of the folowing symptom is the most closly supported diagnosed of this patient?
a.horizontal nystagmus CN palsy limb weakness sensory disturbance
e.normal physiologicaL reflex

138.obat untuk autism?
d.methyl penidate

90.occlusion at penetrating artery -> pure motor hemiparesis. Which caused it?
a.brain cortical infarction
b.lacunar infarction
c.intracerebrla hemmorhage
d.subdural hemmorhage
e.watershed infarction

22.headace, blurred vision, ada tumor supratentorial, yang mana yang rusak?
a.optic tract
b.left optic tract
c.right optic tract
d. optic chiasm long term memory
a.changing action potential
b.changing signal transmission
c.changing neuron
d.changing neurotransmitter production
e.changing neurotransmitter secretion

82.neurotransmitter yang terikat?

10.left eye, drop eyelid, light reflex low, weakness adduksi, weakness to elevate. Yang rusak mana?
a…..pontomedulary junction
b…..left cerebral peduncel

20.sakit trus menarik tangan…….hal yang terjadi…
a.inhibisis eksitasi –flexor otot
b.eksitasi extensor – flexi
c.ekstensi bisep, inhibisi trisep
d.ekstensi trisep inhibet bicep

156.principle of development?
a.gross -> cephalocaudal
b.fine -> cephlalocaudal
c.secuence tiap anak beda
d.rate tiap anak beda
e.development mulai dari neonatus

174. distinguish peripheral and central vertigo
a.dix halpike’s test
b.romberg test
c.gait test
d.calorie test
e.postural test

162.child 6 y.o, problem in concentration, decrease school perfomance, aggressive, normal visual and hearing. Hypothesis?
c.speech delay
d.motor delay
e.mental retardation

179.what exam you should perform to see angle structure?
a.slit map
b.geniscopy fundwcopy
d. rehnoscopy

for no 117 and 118
Ms. G 18 y.o chief compain: choking, shortness of breath, papilation and pounding heart, trembeling , fear of dying

117.BP 130/80, HR 100x/min, RR 20/min, EKG normal, diagnosed panic disorder. The neuroanatomy that involved on her sign and symtom are
a.amygdala and hippocampus
b.prefrontal cortex and sensory association area
c.amygdala and prefrontal cortex
d.lybic system and sensory asiciation area
e.temporal cortex and limbic system

75. 50 years old woman has history of hypertension. This problem increases into cerebral bleeding. Which of the following aneurysma is the most likely to be abrupt?
a. Charcol’s Burchart aneurysm
b. Saccular aneurysm
c. Bery aneurysm
d. Mycotic aneurysm
e. Congenital aneurysm

52. Met. GABa…
a. Sintesis dari glutamate
b. Sintesis dari succinate
c. Katalise menjadi glutamine di…
d. Katalise menjadi glutamine di…
e. Katalise menjadi glutamare di…

54. Alzheimer -> v Ach, which one is true about this?
a. Synthesized by acetyl cholinesterase
b. Acetyl cholinesterase inhibitor augment transmission
c. Cortical nicotinic Ach receptor admit Ca2+
d. Nicotinic receptor at NMJ open K+ channels
e. Nicotinic receptor is implicated in memory process

136. Pervassive disorder yang lebih sering terjadi pada anak perempuan daripada anak laki-laki?
a. autism
b. asperger
c. rett syndrome
d. disorganized pervassive disorder
e. pervassive disorder NOS

186. Symptom = ataxia, headache tumor di cerebellar vermis carrot structure, rossete form
a. epyndioma
b. meningioma
c. tumor of choroid plexus
d. …
e. …

142. The doctor in charge performs light reflex exam to this patient. Which of following function of cranial and examined?
d. V VII

179. What examination you should perform to see angle structure
a. slit lamp
b. gonioscopy
c. direct fundoscopy
d. retinoscopy
e. perimetry

50. 3,5 kg baby delivered cesavean
a. hydrochepalus

100. Obat penyakit di atas (BPPV)
a. antihistamine

122. What defense mechanisme of MDD Introjection

88. Neurotrasmitter yang terlibat dalam cerebral edema saat head injury?
a. dopamine
b. ach
c. glutamate
e. kianate

138. Obat untuk 60y disorder:
a. risperidone
b. Clonidiele
c. buspiron
d. Methylpenidate
e. alparozam

9. After resection of primary tongue tumor 72 years old man mengalami loss sensation in 2/3 anterior lidah, nerve mana yang kena?
b. facial
c. glossopharyngeal
d. trigeminal
e. vagus

80. Woman, memory impairment, forget belonging and need help to find her things, left her bag in aircraft, mixed up phone number, give big tip, get angry with her grandson who said that her cookies were not delicious anymore. Hypothesis?
c. dementia

132. (case di atasnya tentang anak MR, IQ=68) Kemampuannya sampai mana?
a. middleschool – jawaban yang benar
b. high school

182. psamoma body – meningioma
158. First step milestone development
a. head movement
b. runwell
c. sit up /straight back
e. sit before walk

buat 117-118:
Ms G, 189.0 chief complain chocking, shortness breathing, palpitation and pounding heart, trembling and rear of dying.
118. She experienced it when saw blood her mother reported that Ms G very fear of blood. Diagnosis is..
a. agoraphobia
b. specific phobia
c. social phobia
d. aerophobia
e. nonspecified phobia

163. Can’t control bladder, infection UTI. Milestone dev normal. Diag?
a. spinal lymphema
b. spina bifida occulta
c. spina meningioma

71. Ada orang pingsan neck stiffness. Apa?
a. Subdural
b. Epidural
c. Subarachroid nemorhage

72. kok bisa gitu?
a. Nemorhage di court donchart
b. Nemorhage di Berry anearysm
c. embolic

139. A 5 year-old boy was bring to psychiatric by his parents at suggestion of his teachers. His teachers found that he cannot done any task, and he lari keliling2 kelas mengganggu temannya. Di rumah lebih aktif dari dua saudara perempuannya. (intinya ADHD)
Which of the following is the most effective drug for this boy?
a. Risperidon
b. Carbamazepine
c. Haloferidol
d. Methylphenidade
e. Alprazolam

115. soal cerita (lupa)
Efek withdrawal
a. opium
b. canabis
c. benzodiazepin
e. canabis?

126. Development of “Neurotic sign & symptoms” Berhubungan dengan konflik internal antara drive and fear…. Deffense mechanism yang dipakai?
a. Sublimation
b. Repression
c. Regression
d. Symbolization
e. Alzurism

89. A 55 year-old woman has suffered from loss of consciousness during washing. After admitted to hospital, CT scan performed -> intercerebral hemorrhage.
Which of the following is the most possible cause of the result.
a. Diabetes melitus
b. Hypertension
c. Cardiac disease
d. Dislipidemia
e. smoking

102. He had experienced twitching 3 days ago but never visited a doctor. Which is the most suitable diagnosis?
a. Parkinsonism
b. Chorua
c. Epilepsy
d. Stroke
e. Hypocalcemia

70. Male patient, dry mouth, blurred vision after take drug, what drug?
a. Atropine
b. Physostigmine
c. Succinylcholine
d. Prostigmine
e. Salbutamol

120. …………….. diagnosed generalized anxiety disorder. What kind of the generation of adaptive response involved?
a. Cardiovascular & Ectodermal activity
b. Respiratory Psychopathology & Ectodermal avtivity
c. HPA Axis & CRH
d. HPA Axis & skeletomotor
e. HPA Axis & Cardiovascular activity

42. Young woman complain of sudden blurred vision with redness & severe pain in her left eye. There was also nausea & vomit, exam reveal hand movement vision, ciliary inject, corneal edema, middilated pupil, intra occular preasure 50 mmHg. What is the most likely diagnose:
a. acute angle clossure
b. primary open angle glausoma
c. central retinal vein occlusion
d. retinal detachment
e. retrobullar neuritis

79. A woman diagnosed having cardiac embolic stroke. Which is the following most likely unmodifiable risk factor?
a. diabetes melitus
b. obese
c. smocking
d. cardiac disease
e. gender

6. Young girl was spinning in the leftward directed on the playground when she suddenly stopped & felt. Which of the following mechanism first happened?
a. Cupula in right horizontal semi circular canal moved toward utricle
b. left horizontal
c. right vertical
d. right lateral
e. left lateral

28. 20 year old-man got head injury in an automobile accident. He was unconsciousness after head injury, which of teh following part of brain is affected?
a. left temporal
b. right temporal
c. left parietal
d. right parietal
e. right frontal

125. A young male is heavy smoker  m.I after discharge from hospital…. Smoking again deffense mechanism…

100. treatment aleviate..
a. anti confulson
b. analgesic
c. anti platelet
d. anti..

108. If the blood glucose 300 mg/dL. What is the diagnosis
a. radiolopathy
b. polyneuropathy
c. parkinson disease
d. stroke
e. muscle disease

113. A 23 year old-girl dibawa ke emergency room karena suicidal. Dia sudah 3X melakukan percobaan suicide karena berantem sama boyfriend, kata si boyfriend, dia very impulsive, unstable mood, poor relationship. Psychiatric exam : feeling emptiness  Borderline personality disorder

131. Perempuan berusia 11 tahun, IQ = 68. Diagnosis
a. Borderline mental retardation
b. mild mental retardation
c. moderate mental retardation
d. severe mental retardation
e. profound mental retardation

69. Lelaki 67 tahun, tremor, difficult initiate movement. Arm—spasm. Doctor prescribe obat. MOA obatnya:
a. adrenergic agonist
b. serotonic agonist
c. biradykinin agonist
d. acetyl choline antagonist
e. dopamine choline antagonist

46. Kadang klasifikasi tidak terjadi. Ada juga yang di ocipital bone dan otak akan herniasi ke feromone magnum. Apa namanya?
a. mengocele

22. 37 year old-man present with headache with increase in frequency. He also complained about vision blurrring. MRI revealed soft tissue mass on suprasellar extension
23. What other complaint may also revealed?
a. ipsilateral blindness
b. homonymous hemianopsia
c. Homonymous contralateral hemianopsia
d. Heteronymous bitemporal hemianopsia
e. Heteronymous binasal hemianopsia

53. Barbiturates ?
a. Safer than benzodiazepines
b. less selective than benzodiazepines
c. mengikat GBA reseptor yang sama dengan benzodiazepines
d. frekuensi tinggi dan terbukanya Cl- channel
e. Chronic use menyebabkan drug hangover

116. Prompt treatment?
a. Rehabilitasi
b. Detoksifikasi
c. Antagonis opiate
d. Symptomatic treatment

134. Develop from ADHD
a. mental retardation
b. schizophrenia
c. conduct disorder
d. autistic disorder
e. eating disorder

61. A 23 year old unconscious women was brought to ER. Physical examination revealed hypotension, slow breath (10X/min), myosis and increase of bowel sound.
Which of the following is the most CORRECT condition she has?
a. Benzodiazepine withdrawal syndrome
b. Opiate withdrawal syndrome
c. Benzodiazepine overdose
d. Opiate overdose
e. Morphine overdose

111. A 30 year old man, unmanned, lonely, unsociable, social withdrawal, prefer playing computer in his bedroom, has a few friend, has no girlfriend, no haluscination, no delusion.
a. Schizotypal personality disorder
b. Paranoid personality disorder
c. Schizoid personality disorder
d. Avoidant personality disorder
e. Borderline personality disorder

97. Drug used to treat edema in impact stroke?
b. Manittol 20%
d. NaCl 0,9 mL
e. Lactate ringer

147. As non-progressive brain disease, CP child has brain insult on….
a. Prenatal
b. Perinatal
c. Postnatal
d. During brain development
e. After brain maturation

25. Lelaki 50 tahun kecelakaan  dibawa ke ER.
Left examinatio, pupilary constrict, yang kanan dilatasi. CN yang kena?
a. left optic N
b. Right optic N
c. Left Oceulan N
d. Right Oceulan N
e. Trochleon N kiri

75. Lelaki 59 tahun  lost unconscious. Diketahui : Intracerebral remorhage
Aneurysm yang rupture
a. Chariot aneurysm
b. Bery’s aneurysm
c. Saceute aneurysm
d. Myrotic aneurysm
e. Congenital aneurysm

87. Medical appropriate for anti edema?
a. Glicerol 10 %
b. Mannitol 20 %
c. High dose dekamethasone
d. NaCl 0.9 %
e. Ringer lactate

137. Distinguish expression language disorder and autistid disorder?
a. Delayed speech
b. Hyperactivity
c. Normal Hearing test
d. Overly excited
e. Impair social interact

soal2 MDE 2009

Sabtu, 04 Juli 2009

22. Metotrexate termasuk kelas apa?
A. Enzyme
B. Folic acid analog
C. Antibiotic
61. Which of the following is the most likely cause of her missed period?
A. The corpus luteum degenerate
B. A trophoblast is formed that secretes are estrogen and progesterone
C. A trophoblast is formed that secrete is gonadotrophin
D. Decrease production of estrogen and progesterone
E. Negative feedback of estrogen and progesterone on FSH and LH pituitary
67. Cairan amnion yang banyak dapat disebabkan oleh kelainan CNS, penyebabnya adalah…
A. Idiopathic polyhydramnion
B. Umbilical cord compression
70. Sperm analysis shows no spermatozoa. After centrifugation of semen, few spermatozoa are seen.
A. Azoosperma
B. Asperma
C. Oligosperma
D. Cryptosperma
E. Asthenosperma
71. Penyakit di atas adalah…? (kasusnya lupa), dilated vein in left scrotum.
A. Varicocele
72. Kenapa lebih sering scrotum kiri?
A. Pokoknya yang ada nutcrackernya
73. In late pregnancy yang memisahkan maternal blood dan fetal blood?
A. Syncytiotrophoblast only
B. Cytotrophoblast only
C. Syncytiotrophoblast and cytotrophoblast
D. Syncytiotrophoblast, cytotrophoblast, connective tissue and endothelium fetal
E. Syncytiotrophoblast and fetal endothelium
74. Pembentuk amnion
a. syncitio
b. cyto
c. hipo & epi
e. epi & amnioblast
81. Di corpus luteum, progenolon berubah menjadi progesterone. Enzim katalisisnya?
89. A 23 years old woman comes with complaints about a tiny lump just in the opening over the vagina. She had an experience of curettage for hydatidiform mole. Which part that proliferate?
A. Chorion epithel
B. Trophoblast
95. Bagian paling distal dari salphinx
a. infundibulum
b. ampulla
c. isthmus
d. fimbriae
96. A 28 years old has been married for 2 years, with regular intercourse every 2 days. She complained about difficulty to get pregnant. The menstrual cycle was normal, no excessive menstrual bleeding. No history of chronic pelvic pain…dst
102. Woman with 12 week gestation complains dizziness, nausea, and vomiting. What condition responsible?
A. LH rises
B. Corticotrophin rises
C. hCS rises
D. human gonadotropin rises
E. hCG rises
108. A 40 years old woman P5 A0 had history of menorrhagea and anemic. From gynecological examination, found enlarge uterus & anteriorly displace cervix. What is your diagnosis?
A. Cervical cancer
B. Adenomyosis
C. Uterine leomyoma
D. External endometriosis
E. Internal endometriosis
111. A 21 years old primigravida, having vaginal discharge 5 days ago her fundal height is similar 12 weeks, no abdominal cramping, P.E is normal. (ada keterangan 1 lagi tapi lupa, justru itu yang penting, maaf ya). Which of the following is the most likely diagnosis of this case?
A. Missed abortion
B. Threatened abortion
C. Incomplete abortion
D. Partial hydatidiform mole
E. Complete hydatidiform mole
120. Pap smear shows high grade cervical intraepithelial lesion. Conization inappropriate in…?
A. Treatment after CIN biopsy
B. Microinvasion after diagnosis by biopsy
C. Invasive carcinoma after diagnosis by biopsy
139. Woman 24 years old, P2 A0, just delivered vaginally, infant weight 4.300 g after spontaneous uncomplicated labor. She has history with low uterine segment transverse Caesarian for breech. No problem during pregnancy and labor, placenta deliver spontaneously. There is mediate brisk vaginal bleeding greater than 500 cc. Which frequent cause of immediate hemorrhage in this patient?
A. Uterine atony
B. Uterine rupture
C. Coagulophaty
D. Uterine inversion
E. Vaginal and or cervical laceration
146. A 22 years old woman G1 delivered, 9th post-partum day, right breast engorged, hard, red, and painful. T=38, 5°C. Kalo dikultur yang ditemukan?
A. Anaerob Streptococcus
B. E. coli
C. Staphylococcus aureus
D. Aerob Streptococcus
E. Neisherria
155. Bayi lahir dengan C-section. Dalam menit pertama bayinya: irregular gasping, HR 80x/min, fair tone,…
A. No asphyxia
B. Mild asphyxia
C. Moderate asphyxia
D. Severe asphyxia

157. Down syndrome (simian crease, up-slanting palpebral fissure). Test to confirm diagnosis is?
a. serologic
c. serum G6DP deficiency
e. cytogenetic
158. A newborn just born 24 hours ago, physical examination equal upslanting palpebral fissure, simian line on palm. Suspected with Down syndrome. Jika dia ingin punya anak lagi, pemeriksaan apa yang dilakukan pada kehamilan selanjutnya. Apabila ingin memeriksa apakah apakah bayi yang dikandung terkena Down Syndrome atau tidak maka bisa dengan tes…
A. amniocentesis dan chordocentesis
B. chorionic/villus sampling
E. Culture
163. Energy during pregnancy?
A. 100 kcal
B. 300 kcal
C. 500 kcal
D. 700 kcal
E. 900 kcal
164. Risk factor dari kasus di atas adalah…?
165. Amniotic fluid was clear, shortly after birth subcostal and intercostals retraction muncul. Kenapa terjadi respiratory distress?
B. Primigravida
C. C-sectio
E. Mucositic aspiration
172. Exclusive breast feeding dapat mengurangi risiko…
A. diare
B. impertigo
C. urinary tract infection
D. asthma
E. conjunctivitis
175. A 30 years old woman with vaginal itching & discharge. Her husband complains of penile skin rash.
A. Trichomonas
B. Candida
C. Gonorrhea
D. Herpes
E. Cacing ??
181. Maturation Index (MI) of 80/10/10 most likely cause of above result:
A. Trichomonas vaginalis infection
B. Long term used of injection contraceptive
C. Age of patient
D. Chronic cervicitis
E. Estrogen level 
189. A biopsy of reddish breast nodule from 35 years old woman showed histological appearance of tubercle with central necrosis within breast tissue. Which is the best diagnosis?
A. Acute mastitis
B. Lactating adenoma
C. Fat necrosis
D. Mammary duct ectasia
E. Mastitis tuberculosis

21. Seorang anak fatigue dan menderita konstipasi dlaam 1 tahun belakangan, ada juga sindrom weight gain, dll.
Jawaban: hypothyroidsm
35 y0, housewife. chief complain : fatigue & lose of body weight. dia juga merasakan excessive thirst & urinate frequently. 6 bulan yg lalu : numbness in her feet & ...(utk no. 75 dan 76)
75. what further information to get the diagnosis?
a. Fatty acid level in blood
b. Amino acid level in blood
c. Glucose level in blood
d. Ureum level in blood
e. Creatinine level in blood

76. an oral glucose tolerance test (OGTT) is tested in this patient. which of the following is the most likely diagnosis confirmed with this test?
a. DM type I
b. DM type II
c. IGT (impair glucose tolerance)
d. diabetic ketoacidosis
e. DM with hypoglycemi

102. which metabolic changes of polyol pathway that responsible for the condition of this patient?
C. accumulation of sorbitol

21/71 Ada orang ngambil kompor panas, terus langsung narik tangan, fiber yg bekerja utk pain adalah
A. fast C fiber
B. slow C fiber
C. fast a alfa fiber
D. fast a beta fiber
E. fast a delta fiber
21/71 55 y.o tiba2 severe headache, vomiting
A. intracerebral hemorrhage
B. lacunar
C. subarachnoid hemorrhage
D. arterioemboli
E. cardioemboli
148. Kern Icterus merupakan slah satu ciri dari CP. neuropathology featurenya
A. Perventricular leucomalacia
B. Basal ganglia abnormalities
C. Brain calcification
D. Brain infarction

198. Untuk mendeteksi cardio emboli
C. Pulse rate
D. Heart rate
E. X-ray

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